Sexual Practices Values Clarification: An Exercise for ...

AMSA Sexual Health Scholars Program

Sexual Practices Values Clarification: An Exercise for Health Care Professionals and Students

Purpose Sexual health is an integral part of any person's overall health, and many practitioners do

not feel entirely comfortable asking detailed questions regarding sexual practices. One of the most common reasons given by practitioners for not asking about sexual health issues is embarrassment. Additionally, patients often report "physician discomfort and anticipated nonempathetic response to sexual problems are the primary barriers to discussing sexual health" [1]. This is particularly true in the case of LGBT patients, where studies have shown that "providers often feel ill-prepared to discuss intimate issues, or feel uncomfortable doing so" [2]. One step in the process of removing these barriers and uncomfortable feelings is by becoming self-aware of our own comfort level regarding different sexual practices.

The function of this handout is to help health professions students and practitioners examine their own beliefs, values, and attitudes related to different sexual practices. Values clarification exercises help to illuminate our own personal biases and attitudes towards a range of different, often deeply personal, topics. By addressing our internal values, we can then use this insight to provide more thorough, inclusive sexual health care in the clinical setting.

Objectives ? Identify external factors that have influenced our values regarding different sexual practices ? Identify personal experiences that have shaped our values towards different sexual practices ? Evaluate our obligations as health care providers towards patients with values that may be different than our own

How to Use This Worksheet ? A medium-sized group setting would be ideal for using this worksheet (~15-20 individuals). However, it can also be used in large groups. In this case, the group should be split into smaller sections for the discussion portion (section V). ? The first four sections are completed individually. A time allotment of approximately 30 minutes should be given for their completion. ? After the participants have completed the first four sections, the final section can be used in a discussion regarding caring for patients that engage in sexual practices that fall outside of our own values. ? Overall, this worksheet should be used to help health practitioners evaluate their own values regarding sexual practices in order to provide better sexual health for their patients.

Limitations ? This worksheet was designed with the intent to be as inclusive of different sexual practices as possible. Admittedly, there are many practices left out. For each question of Section II, part 2, there is space to fill in practices not explicitly addressed. ? Additionally, this worksheet uses gender-specific terms. Please make appropriate changes to wording and terminology to reflect non-gender specificity if desired.

I. How Do External Factors Influence Our Values? The purpose of this section is to evaluate the influence core beliefs and attitudes from

external areas have on your present ideas about sexual practices. Please reflect on these questions in the space provided. 1. Family

a. Did the family you were brought up in discuss specific sexual practices that were regarded as "acceptable" and "unacceptable"? ____________________________________________________________________ ________________________________________________________________

b. Have there been any family events that changed your views while you were living with your family? ____________________________________________________________________ ________________________________________________________________

c. Describe any differences between your current values about sexual practices and those of your family. ____________________________________________________________________ ________________________________________________________________

2. Social Group: a. Does the culture/social setting to which you belong influence your attitudes/beliefs about "acceptable" and "unacceptable" sexual practices? If so, in what way? ____________________________________________________________________ ________________________________________________________________ b. Has anything occurred that led you to develop a different set of values than those dominant in your culture/social setting? ____________________________________________________________________ ________________________________________________________________ c. Describe any differences between your current values and those of your culture/social setting. ____________________________________________________________________ ________________________________________________________________ d. Have your friends influenced the sexual practice values you currently hold? If so, in what way? ____________________________________________________________________ ________________________________________________________________

3. Spiritual/Religious Beliefs a. Have you held the same spiritual beliefs since childhood? ____________________________________________________________________ ________________________________________________________________ b. If you currently espouse to one form of spiritual/religious belief, does it influence your values regarding sexual practices? ___Yes ___ No If so, in what way? ____________________________________________________________________ ________________________________________________________________ c. Describe any differences in values about sexual practice you may have compared to your spiritual background. ____________________________________________________________________ ________________________________________________________________

4. School/teachers (including primary, secondary, college, and medical/nursing/PA, etc school)

2

a. Did your education include information about different sexual practices? If so, at what level? ____________________________________________________________________ ________________________________________________________________

b. Did the attitudes and information in sex education conflict with those of your family, social group, or religion? ___ Yes ___ No i. If so, how have you dealt with those conflicts? ______________________________________________________________ __________________________________________________________

5. Media (including music, movies, newspaper, internet, etc) a. Has the media shaped your values and beliefs regarding sexual practices? ___Yes ___ No i. If yes, in what way? _______________________________________________________________ ___________________________________________________________ b. Which of the following media forms have most greatly influenced your values? ____ TV shows ____ TV news ____ Movies ____ Newspapers ____ Magazines ____ Internet ___ News sites ___ Blogs ___ Social sites (Facebook, Twitter, MySpace, etc): ___ Porn sites ___ Other: ___________________________________ i. Other media: _____________________________________ c. Has the media challenged your values regarding sexual practices? If so, in what way? _______________________________________________________________ ___________________________________________________________

II. How Do Personal Experiences Shape Our Values? In addition to external influences, our own personal sexual experiences can influence our beliefs and attitudes regarding certain practices. Please reflect on the effect of your personal experiences in the space provided. 1. Personal experiences of sexual intimacy and sexual practices a. Was your first experience of sexual intimacy well planned or spontaneous? ____________________________________________________________________ ________________________________________________________________ i. Given your present perspective, is there anything you would change about your first experience? ____________________________________________________________ ________________________________________________________ b. How healthy would you consider your sex life at this point? ____________________________________________________________________ ________________________________________________________________

3

c. Has a partner ever asked you to perform a sexual act that you considered unacceptable? ___ Yes ___ No If yes, how did you react? ____________________________________________________________________ ________________________________________________________________

d. Which of the following have had an effect on your personal sexual experiences: ____ Sexual abuse or sexual assault ____ Coercive sex ____ Sexual infidelity (yours or partner's) ____ Sexually transmitted disease ____ Drugs or alcohol ____ One night stand ____ Uncertainty in sexual orientation (yours or partner's) ____ Inability to orgasm ____ Other: ___________________________

2. Personal attitudes about sexual practices a. Which of the following coincide with what you consider acceptable sexual practice from your own experience: ____ Abstinence until marriage ____ Oral sex only before marriage (no penetrative, vaginal or anal) ____ Any form of sex before marriage ____ Masturbation, alone ____ Masturbation, with others ____ Oral sex: mouth-to-vulva, -penis, -anus ____ Penis-in-vagina sex ____ Penis-in-anus sex ____ Other: ___________________________ b. Would you consider your attitudes regarding different sexual practices to be broad or narrow? Why? _______________________________________________________________________ ___________________________________________________________________

III. Examining Our Potential Biases Towards Patients with Sexual Practices Different from Our Own

1. For the following, please respond in the space provided with your first feeling/attitude about the following sexual practices: a. Kissing and Fondling _________________________________________________________________ _____________________________________________________________ b. Masturbation i. Alone _____________________________________________________ ii. Mutual ____________________________________________________ iii. With toys __________________________________________________ iv. Other _____________________________________________________ c. Vaginal Sex i. Male-Female _______________________________________________ ii. Female-Female _____________________________________________ iii. Other insertive practices ______________________________________

4

d. Anal Sex i. Male-Female _______________________________________________ ii. Male-Male _________________________________________________

iii. Female-Female _____________________________________________ iv. Other insertive practices ______________________________________ e. Oral Sex i. Fellatio (mouth-to-penis) _____________________________________ ii. Cunnilingus (mouth-to-vulva) _________________________________ iii. Anal (mouth-to-anus) ________________________________________ iv. Other mouth-to-genital practices _______________________________ f. Paraphilias [3] i. Asphyxiophilia (dependent on partial asphyxiation to obtain arousal and

facilitate or achieve orgasm): __________________________________________________________ ii. Exhibitionism (dependent on surprise, debasement, shock, or outcry of a stranger unexpectedly exposed to the sight of a penis to obtain arousal and facilitate or achieve orgasm): __________________________________________________________ iii. Fetishism (dependent on a specific object, substance, or body part to obtain arousal and facilitate or achieve orgasm): __________________________________________________________ iv. Masochism (dependent on being punished and humiliated to obtain arousal and facilitate or achieve orgasm): __________________________________________________________ v. Pedophilia (dependent on imagery or actuality of sexual activity in a prepubertal/early pubertal boy or girl to obtain arousal and facilitate or achieve orgasm): __________________________________________________________ vi. Sadism (dependent on punishing or humiliating one's partner to obtain arousal and facilitate or achieve orgasm): __________________________________________________________ vii. Voyeurism (dependent on illicitly looking at an individual or a couple undressing or engaged in sexual activity to obtain arousal and facilitate or achieve orgasm): __________________________________________________________ viii. Zoophilia (dependent on sexual activity with an animal to obtain arousal and facilitate or achieve orgasm): __________________________________________________________ ix. Other paraphilias ____________________________________________ g. Age: in the following age ranges, which do you consider acceptable practice? i. Childhood (0-12):

____ Genital touching of others ____ Masturbation ____ Sex (oral, vaginal, anal) ____ Other: ___________________________ ____ None of the above ii. Adolescence (13-19): ____ Masturbation

5

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download